Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease.

Autor:	Smid DE; Department of Research and Education, CIRO, Horn, The Netherlands. Electronic address: dionnesmid@ciro-horn.nl., Franssen FME; Department of Research and Education, CIRO, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Gonik M; Biomax Informatics AG, Planegg, Germany., Miravitlles M; Pneumology Department, Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain., Casanova C; Pulmonary Department and Research Unit, Hospital Universitario NS La Candelaria, Santa Cruz de Tenerife, Spain., Cosio BG; Department of Respiratory Medicine, Hospital Son Espases-IdISPa-CIBERES, Islas Baleares, Spain., de Lucas-Ramos P; Hospital General Universitario Gregorio Marañon, Pulmonary Department, Madrid, Spain., Marin JM; Hospital Universitario Miguel Servet, IISAragon, CIBER Enfermedades Respiratorias, Zaragoza, Spain., Martinez C; Pneumology Service Instituto Nacional de Silicosis-Hospital Universitario Central de Asturias, Oviedo, Spain., Mir I; Hospital General Universitario Gregorio Marañón, Madrid, Pulmonary Department, Madrid, Spain., Soriano JB; Instituto de Investigación Hospital Universitario de la Princesa, IISP, Universidad Autónoma de Madrid, Madrid, Spain., de Torres JP; Pulmonary Department, Clinica Universidad de Navarra, Pamplona, Spain., Agusti A; Respiratory Institute, Hospital Clinic, University of Barcelona and CIBERES, Spain., Atalay NB; Department of Psychology, TOBB University of Economics and Technology, Ankara, Turkey., Billington J; Central Surgery, Surbiton Health Centre, Surbiton, Surrey, United Kingdom., Boutou AK; Intensive Care Unit, G Gennimats, General Hospital, Thessaloniki, Greece; Respiratory Failure Unit, Aristotle University of Thessaloniki, Greece., Brighenti-Zogg S; University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland., Chaplin E; Center for Exercise and Rehabilitation Science, NIHR Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom., Coster S; King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, United Kingdom., Dodd JW; Academic Respiratory Unit University of Bristol, North Bristol Lung Centre, Southmead Hospital Bristol, United Kingdom., Dürr S; University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland., Fernandez-Villar A; Servicio de Neumología, Instituto de Investigación Biomédica de Vigo, IBIV, Complexo Hospitalario de Vigo, Vigo, Pontevedra, España., Groenen MTJ; Department of Research and Education, CIRO, Horn, The Netherlands., Guimarães M; Pulmonology Department of Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal., Hejduk K; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Higgins V; Adelphi Real World, Bollington, United Kingdom., Hopkinson NS; NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust, Imperial College London, London, United Kingdom., Horita N; Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Houben-Wilke S; Department of Research and Education, CIRO, Horn, The Netherlands., Janssen DJA; Department of Research and Education, CIRO, Horn, The Netherlands., Jehn M; Arbeitsbereich Ambulante Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany., Joerres R; Institute and Output Clinic for Occupational and Environmental Medicine, Munich, Germany., Karch A; Institute for Biostatistics, Hannover Medical School, Hannover, Germany., Kelly JL; Academic Unit of Sleep and Ventilation, National Heart and Lung Institute, Imperial College London, NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton, United Kingdom; Harefield NHS Foundation Trust and Imperial College, London, United Kingdom., Kim YI; Division of Pulmonology, Department of Internal Medicine, Chonnam National University Hospital, Donggu, Gwangju, South Korea., Kimura H; Second Department of Internal Medicine, Nara Medical University, Nara, Japan., Koblizek V; Department of Pneumology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic., Kocks JH; Department of Primary Care, Groningen Research Institute for Asthma and COPD, GRIAC, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Kon SSC; The Hillingdon Hospital NHS Foundation Trust, United Kingdom; NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, United Kingdom., Kwon N; Respiratory Franchise Medical, GlaxoSmithKline (GSK), London, United Kingdom., Ladeira I; Pulmonology Department of Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal., Lee SD; Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Leuppi JD; University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland., Locantore N; GlaxoSmithKline, King of Prussia, PA., Lopez-Campos JL; Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, IBiS, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain; CIBER de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain., D-C Man W; NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, United Kingdom., Maricic L; University Hospital Osijek; Department of Internal Medicine; Faculty of Medicine, University J.J Strossmayer Osijek, Osijek, Croatia., Mendoza L; Hospital Clínico Universidad de Chile, Región Metropolitana, Chile., Miedinger D; University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland., Mihaltan F; Institute of Pneumology Marius Nasta, Bucharest, Romania., Minami S; Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan., van der Molen T; Department of Primary Care, Groningen Research Institute for Asthma and COPD, GRIAC, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Murrells TJ; King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, United Kingdom., Nakken N; Department of Research and Education, CIRO, Horn, The Netherlands., Nishijima Y; Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan; Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Suita, Osaka, Japan., Norman IJ; King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, United Kingdom., Novotna B; Department of Pneumology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic., O'Donnell DE; Department of Medicine, Queen's University and Kingston General Hospital, Kingston, ON, Canada., Ogata Y; Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan., Pereira ED; Federal University of Ceará-Brazil, Fortaleza, Brazil., Piercy J; Adelphi Real World, Bollington, United Kingdom., Price D; Observational and Pragmatic Research Institute, Singapore; University of Aberdeen, Aberdeen, United Kingdom., Pothirat C; Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Raghavan N; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Ringbaek T; Department of Respiratory Medicine, Hvidovre Hospital, University of Copenhagen, Denmark., Sajkov D; Australian Respiratory and Sleep Medicine Institute, Flinders Medical Center, Adelaide, Australia., Sigari N; Internal Medicine Department, Medical Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran., Singh S; Center for Exercise and Rehabilitation Science, NIHR Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom., Small M; Adelphi Real World, Bollington, United Kingdom., da Silva GF; University of Fortaleza/UNIFOR, Fortaleza, Brazil., Tanner RJ; NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust, Imperial College London, London, United Kingdom., Tsiligianni IG; Department of Primary Care, Groningen Research Institute for Asthma and COPD, GRIAC, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; Agia Barbara Health Care Center, Heraklion Crete, Greece., Tulek B; Department of Chest Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey., Tzanakis N; Department of Thoracic Medicine, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece., Vanfleteren LEGW; Department of Research and Education, CIRO, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Watz H; Pulmonary Research Institute at Lung Clinic Grosshansdorf, German Center for Lung Research, Grosshansdorf, Germany., Webb KA; Department of Medicine, Queen's University and Kingston General Hospital, Kingston, ON, Canada., Wouters EFM; Department of Research and Education, CIRO, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Xie GG; Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, China., Yoshikawa M; Second Department of Internal Medicine, Nara Medical University, Nara, Japan., Spruit MA; Department of Research and Education, CIRO, Horn, The Netherlands; REVAL, Rehabilitation Research Center, BIOMED, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2017 Dec 01; Vol. 18 (12), pp. 1097.e11-1097.e24.
DOI:	10.1016/j.jamda.2017.09.003
Abstrakt:	Background: Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference. Methods: After a computerized search, data from 41 cohorts and whose authors agreed to provide data were pooled. COPD studies were eligible for analyses if they included, at least age, sex, postbronchodilator spirometry, modified Medical Research Council, and COPD Assessment Test (CAT) total scores. Main Outcomes: Receiver operating characteristic curves and the Youden index were used to determine the best calibration threshold for CAT, COPD Clinical Questionnaire, and St. Georges Respiratory Questionnaire total scores. Following, GOLD A/B/C/D frequencies were calculated based on current cut-points and the newly derived cut-points. Findings: A total of 18,577 patients with COPD [72.0% male; mean age: 66.3 years (standard deviation 9.6)] were analyzed. Most patients had a moderate or severe degree of airflow limitation (GOLD spirometric grade 1, 10.9%; grade 2, 46.6%; grade 3, 32.4%; and grade 4, 10.3%). The best calibration threshold for CAT total score was 18 points, for COPD Clinical Questionnaire total score 1.9 points, and for St. Georges Respiratory Questionnaire total score 46.0 points. Conclusions: The application of these new cut-points would reclassify about one-third of the patients with COPD and, thus, would impact on individual disease management. Further validation in prospective studies of these new values are needed. (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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